You may need to always wear a compression garment, particularly during times of increased physical activity. Compression therapy to a swollen limb can be provided in two ways:
- Compression hosiery (an elastic sleeve or stocking)
- Multilayer compression bandaging
A firm, supportive bra may be helpful for breast swelling. Compression therapy isn't usually offered as a treatment method for swelling of the head and neck, but there is a garment available for facial swelling.
Most people with lymphoedema are fitted with compression hosiery. It is designed to limit the formation of lymph. It provides resistance against which the muscles can pump and move lymph more effectively. Limb size shouldn't increase and sometimes may be reduced. Extra layers increase compression so you may be asked to wear more than one garment at a time.
You should put on your compression sleeve, stocking or tights first thing in the morning and remove them last thing at night. When you start wearing hosiery it will probably feel strange. You may like to wear your sleeve, stocking or tights for a few hours on the first day, gradually increasing the time. By day three or four, you should be wearing it all day.
Your hosiery may be difficult to put on but your lymphoedema therapist will help you with this and show you the best way. You may find that wearing ordinary household rubber gloves allows you to get a firmer grip. If you continue to have difficulty, you may be able to buy a special applicator.
Once your hosiery is on it should feel firm, supportive and, above all comfortable. If you notice a change in the colour of your fingers or toes or any new tingling, numbness or pain in your limb, remove your hosiery straight away. If you have any problems at all, with the fit or comfort of your garment, contact your lymphoedema therapist.
You will be given one sleeve, one stocking or one pair of tights and a second garment will be requested from your family doctor (GP) on prescription so you can wash one and wear one. If you are wearing more than one garment, you should be given two sets. Try to wear each item equally. Your hosiery should be washed, every two to three days, at 40 degrees or less and allowed to dry naturally. Use a mild washing powder or liquid, such as one recommended for woollens or delicate fabrics, as detergents can damage the garments. Instructions may vary with the make of garment so check these carefully.
Compression garments are available in a few different colours depending on the style and the make. You will need replacement sleeves, stocking or pairs of tights every four or six months because they lose their compression over time. Who supplies your garments will depend on where you have been referred for your lymphoedema treatment. It may be your family doctor or the appliance officer at your local hospital. If you have any questions about your hosiery you can ask your lymphoedema therapist.
You will not have to pay a prescription charge for your compression garments once you have completed form FP92A to apply for a certificate which entitles people with a cancer diagnosis to free prescriptions. You may purchase additional garments at the full price if you wish.
Multilayer compression bandaging
This is used to provide compression when:
- Conventional hosiery is not available for a particular size or shape of limb
- The skin is fragile and may be damaged by putting on and removing hosiery.
Several layers of bandaging and foam pads will be applied to your limb to give even compression and to reshape it. The layers will also protect your skin. Your lymphoedema therapist will usually do the bandaging. Sometimes you may be taught to do this yourself. A course of multilayer compression bandaging lasts for about three weeks. The bandages are usually renewed every weekday, to maintain compression. Your lymphoedema therapist will also check the condition of your skin each time you attend, when you can wash your limb. The first treatment usually takes about an hour and then each daily session may be between 30 minutes and one hour.
If you have been offered a course of multilayer compression bandaging, you will be given a card listing the dates and times of your appointments. You will be asked to bring a washcloth, soap, towel and your moisturiser, so you can wash your limb before it is re-bandaged. If you live too far away to travel to the hospital each day, you may be offered an alternative treatment plan (for example three days each week). In some circumstances you may be admitted to hospital for treatment.
While you are having multilayer compression bandaging, you will need to wear loose fitting clothes to allow for the bulk of the bandages. If you are having your leg(s) bandaged, you should wear large lace-up shoes, such as trainers about two sizes bigger than usual. These will enable you to walk in comfort, safely and at a reasonable speed. Slippers aren't a good idea as they are unlikely to fit securely over the bandages. If you are unable to find suitable footwear, you may be offered a plaster shoe.
If you have a swollen arm or leg and you are planning to drive yourself to the hospital, you will be advised to wear this garment day and night for the first few weeks to maintain the benefit of the bandages. You are strongly advised to check that your motor insurance company covers you. When you finish your course of treatment you will be fitted with a compression garment to maintain your limb size. If necessary, a second course of multilayer compression bandaging may be offered later.
If you are offered a course of treatment with multilayer compression bandaging you may be given a leaflet containing more detailed information.